Cardiac glycoside resistant non-immunogenic selection marker

ABSTRACT

A recombinant Na + , K + -ATPase α1-subunit protein resistant to cardiac gIycosides, e.g. oubain, is disclosed, as well as methods for its production and use. The resistance to cardiac glycosides are obtained b y alterations in the region situated between and including the amino acids 65-133. Such recombinant protein and nucleic acid constructs expressing the same are useful as selection markers in gene therapy and research applications.

FIELD OF THE INVENTION

The present invention relates to the field of biotechnology, and in particular to a recombinant human protein and the corresponding nucleic acid construct, as well as to methods of their use in therapy and research, said protein being resistant to cardiac glycosides, in particular an ouabain resistant Na⁺, K⁺-ATPase alpha1 subunit.

BACKGROUND OF THE INVENTION

Gene therapy is an approach to treat diseases either by modifying the expression of one or more genes of an individual, or by correcting abnormal genes. By administration of DNA rather than a drug, many different diseases are currently being investigated as candidates for gene therapy. These include genetic disorders, e.g. cystic fibrosis, cardiovascular disease, various forms of cancer, as well as infectious diseases such as AIDS. When transferring genes to cells ex vivo or in vivo, a selection is often required, if the gene modified cells do not have a selective advantage over unmodified cells. It could also be desirable to ensure sufficient multiplication of the cells having received the new gene before transferring them to the patient.

The practical use of gene therapy is still limited due to various reasons, one of them being low gene transfer efficiency and the requirement for extended in vitro cell culture selection to obtain enriched or pure populations of gene modified cells. Different marker genes for selection of gene-modified cells have hitherto been used. These fall into two categories: cell surface markers and metabolic selection markers.

Cells modified by cell surface marker genes can be selected by fluorescence-activated cell sorting (FACS) or by immunomagnetic techniques. Cell surface markers usually allow fast selection procedures, but there is a risk of false-positive selection if the selection is performed too early following the transduction, due to transfer of the marker protein in the retroviral envelope to the target cell plasma membrane. Further, FACS is an open system leading to difficulties in maintaining sterility. In addition, sorting large amounts of cells takes considerable time. A general drawback of immunomagnetic sorting is the low recovery of gene-modified cells. Only cells with high transgene expression are efficiently sorted. Low recovery requires larger volumes of starting materials and is economically unfavourable.

Metabolic selection markers allow for efficient background-free selection of the gene-modified cells, but the duration of selection is usually long, typically lasting about one week to ten days. The selection substance may also be directly DNA damaging.

Further, there is a great risk of non-human genes or gene fragments to trigger an immune response against gene modified cells. Thus, human cells modified with these genes would be eliminated by the immune system. Immunogenicity is usually not a problem with cell surface markers since these are generally human. In contrast, metabolic selection markers are often of non-mammalian origin, documented to cause immunogenicity problems.

Another problem with current selection markers is their putative influence on normal cell functions. This poses a risk of causing cell alterations which might contribute to cell transformation.

Na⁺, K⁺-ATPase is a housekeeping enzyme present in all mammalian cells. It is an integral membrane protein that establishes the electrochemical gradient across the plasma membrane by transporting sodium ions out of the cell and potassium ions into the cell (in the ratio 3:2), utilising ATP hydrolysis as an energy source. Variations in the activity of the Na⁺, K⁺-ATPase have effects on a number of critical cell functions. The minimal functional enzyme active in the membrane is a dimer consisting of an α-subunit and a β-subunit. Four isoforms (α₁,α₂,α₃, and α₄) of the Na⁺, K⁺-ATPase α-subunit gene family have been cloned in man and rat, the a being the most resistant isoform to cardiac glycosides.

Cardiac glycosides are naturally occurring compounds found to have an effect on the contractive power and rhythm of the mammal heart. Examples include digoxin and digitoxin, from woolly foxglove (Digitalis lanata) and from common foxglove (Digitalis purpurea); proscillaridine A from sea squill, (Urginea (Scilla) maritime), ouabain (G-strophantine) from Strophantus gratus; convallatoxin from mayflower (Lily-of-the-valley, Convallania majalis); and palytoxin from the coral Palythoa toxica. All cardiac glycosides seem to comprise a steroidal part, coupled to one or more glucose like molecules.

Ouabain, one member of the above group of drugs, has been shown to bind to the α-subunit and inhibits the ATPase and ion-transport activity of the enzyme. In this description, ouabain is used as one example of cardiac glycosides.

As mentioned above, current selection methods have several shortcomings negatively influencing the cell selection. Accordingly, there is a need for a rapid selection marker for use in in vitro applications as well as in human gene therapy with high efficiency and minimal immunogenicity. Such a marker would also have wide application in methods for studying the toxicology of drugs, studying the mechanisms of toxicity, screening for new drugs in vitro, etc.

One objective of the present invention is to make available such a marker, as well as methods of its production and use. Further objectives, the solutions offered by the invention, as well as their advantages will be evident to a skilled person upon study of the following description and examples.

Prior Art

There is a large naturally occurring difference in ouabain sensitivity among different mammalian species. Rat and mouse Na⁺, K⁺-ATPase proteins exhibit high resistance to cardiac glycosides, whereas human sheep, monkey and pig proteins are highly sensitive (Kuntzweiler et al., J. Biol. Chem., 271: 29682-29687,1996). As early as 1988, Price and Lingrell (Biochemistry, 1, 27: 8400-8408), suggested that the determinants involved in ouabain sensitivity of the sheep protein are located in the amino-terminal half of the Na⁺, K⁺-ATP α subunit. Several attempts have been made to increase the resistance of different, non-human Na⁺, K⁺-ATPases, however with varying success and a highly resistant phenotype of rat Na⁺, K⁺-ATPase has not been reached.

U.S. Pat. No. 6,309,874 (Belusa) presents a selection system based on the rat Na⁺, K⁺-ATPase α₁ gene comprising point mutations at the amino acid positions 799 and/or 801 and transfected into non-human mammalian cell lines.

Coppi et al. (Biochemistry, 38:24942505, 1999) studied the effects of combinations of charged residues at the M1-M2 loop border on ouabain affinity of the α₁ and α₂ rat isoforms. They report that the ouabain sensitivity of the rat Na⁺, K⁺-ATPase is dependent not only on the identity of the M1-M2 loop border residues but also on the environment into which they are introduced. They also suggest that these residues might affect ouabain sensitivity by destabilizing or altering the E2 conformation of the Na⁺, K⁺-ATPase to which ouabain preferentially binds.

De Fusco et al. (Nature Genetics, 33:192-196, 2003—published 21 Jan. 2003) studied mutations in the gene encoding the α₂ subunit of human Na⁺, K⁺-ATPase and their association with familial hemiplegic migraine type 2. To investigate the ion transport function of mutated α₂ and β₂ subunits they used the Na⁺, K⁺-ATPase activity. The α₂ and β₂ subunits were made ouabain resistant by introducing two amino acid mutations, Q116R and N127D, in the first extra cellular loop. However, the homology at the amino acid level between the α₁ and α₂-isoforms in human Na⁺, K⁺-ATPase is low, i.e. only about 87%, and performing the same mutations in the α₁-gene can therefore not be assumed to have the same desired effect.

Aints et al. (Human Gene Therapy, 13:969-977, 2002) achieved increased resistance to ouabain in human cells using the rat Na⁺, K⁺-ATPase α₁ subunit, in which leucine at position 799 was substituted for a cysteine by targeted mutagenesis.

Emanuel et al. (Mol. Cell Biol., 9:3744-3749, 1989) studied determinants within the Na⁺, K⁺-ATPase α subunit that contribute to differential ouabain sensitivity. They constructed chimeric cDNA molecules between ouabain-resistant and ouabain-sensitive α subunit cDNAs. By substituting the 5′ end of the human α1 subunit with the 5′ end of rat α1 cDNA Emanuel et al. obtained a recombinant protein comprising, in the amino terminal, 172 amino acid residues of the rat α1 subunit. The construct was transfected into African green monkey CV-1 cells and the recombinant Na⁺, K⁺-ATPase showed to be resistant to 10⁻⁴M ouabain. However, this construct was never transfected into human cells and the functionality and immunogenicity of said construct in human cells can be not be estimated from this study. A construct with such a large substitution deriving from a rat gene is likely to confer high immunogenicity in human cells and is therefore not suitable as a selection marker for use in human gene therapy.

In conclusion, the prior art describes the Na⁺, K⁺-ATPase biology but does not provide evidence to the identification of amino acids conferring increased resistance to ouabain in the human Na⁺, K⁺-ATPase α1 subunit and therefore does not succeed in providing evidence to, or suggestion for the human Na⁺, K⁺-ATPase α1 gene to develop into an efficient selection marker for human gene therapy. In conclusion, there remains a need for a non-immunogenic, rapid and reliable selection marker for use in human gene therapy and research.

SUMMARY OF THE INVENTION

The present invention relates to a recombinant human Na⁺, K⁺ ATPase protein with increased cardiac glycoside resistance, and in particular to a recombinant human Na⁺, K⁺ ATPase α1-subunit polypeptide confereing such increased cardiac glycoside resistance. The said recombinant protein is at least 98% homologous to the corresponding human Na⁺, K⁺ ATPase α1-subunit at amino acid level. The dissimilarity in amino acid sequence between the recombinant α1-subunit and the corresponding human Na⁺, K⁺ ATPase α1-subunit is situated between and including the amino acids corresponding to number 65-133 of the human Na⁺, K⁺ ATPase α1-subunit of SEQ ID NO. 1 or equivalent functional homologues thereof.

The attached sequence listing (prepared using the PatentIn 3.1 software) discloses the amino acid sequence for a human wild type Na⁺, K⁺-ATPase α1-subunit (SEQ ID NO. 1), the amino acid sequence of a recombinant Na⁺, K⁺-ATPase according to one embodiment of the invention (SEQ ID NO. 2), and the recombinant nucleic acid coding sequence corresponding to said protein (SEQ ID NO. 3). The primers used in the examples are disclosed as SEQ ID NO. 4-21. The amino acid sequence exhibiting the minimal 2 amino acid substitutions is disclosed as SEQ ID NO. 23 and the corresponding coding sequence as SEQ ID NO. 24, both constituting a preferred embodiment of the invention.

Further aspects of the invention and their advantages will become evident from the following description, example, drawings and the attached claims, incorporated herein by reference.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be described in closer detail in the following description, examples, and attached drawings, in which

FIG. 1 shows a schematic representation of the constructs that were tested for resistance to ouabain induced cell death. HeLa and COS-7 cells transfected with plasmids containing these constructs were incubated in 10 μM ouabain for 24 hours and 4 days respectively, followed by analysis. The top six constructs conferred resistance to ouabain induced cell death, while the eight constructs below did not.

FIG. 2 shows graphically the results of selection of HeLa cells with ouabain after transient transfection. Ouabain was added to the cells 24 hours post transfection. 48 h after transfection cells were trypsinized and transferred to ouabain free medium. The next day cells were washed with PBS and analyzed using WST-1 cell proliferation reagent. Cells were either un-transfected (control), or transfected with the C1 plasmid coding for the EGFP in frame with rat OuaR (PEGFPR) or with human Na⁺,K⁺-ATPase α1 cDNA carrying amino acid substitutions Q118R, N129D (pEGFP-Q118R; N129D)

DETAILED DESCRIPTION OF THE INVENTION

In the context of the present description and claims, the term “functionally homologous” or “functional equivalent” refers to a property of sequences sharing perhaps a lower structural homology with the disclosed sequence, but exhibiting homologous function in vivo and/or in vitro, in either the healthy or the diseased organism, e.g. coding the same or highly similar proteins sharing the same or highly similar cellular functions. The most relevant cellular functions are in this case the increase resistance to cardiac glycosides, and the low or non-existing immunogenicity.

The present invention relates to a new and efficient selection marker for use in cell culture experiments and in molecular biology, e.g. for the selection of human cells. The invention is based on a gene that is naturally expressed in all cells, i.e. the Na⁺, K⁺-ATPase α1 subunit gene. By minimal alteration of normal protein activity an efficient selectable marker for use in human gene therapy is established that allows for rapid elimination of unmodified human cells with ouabain and efficient recovery of gene modified cells. Due to minimal alteration of a naturally occurring gene, the selection marker confers no or very low immunogenicity.

The present invention is based inter alia on the results from an experiment wherein the nucleotide sequence coding for the first about 130, preferably the first 133 amino acids in the amino terminal of the human Na⁺, K⁺-ATPase α1 subunit cDNA was substituted with the corresponding part of the rat Na⁺, K⁺-ATPase α1 subunit cDNA. The rat homologue of the human Na⁺, K⁺-ATPase α1 subunit confers significantly higher resistance to ouabain toxicity. The present inventors have surprisingly shown that the chimeric α1-subunit coded by this chimeric cDNA exhibits a significantly increased resistance to the cardiac glycoside ouabain compared to human Na⁺, K⁺-ATPase α1. The chimeric α1-subunit codes for a different amino acid at ten positions from the human α1-subunit. Thus, the difference between the chimeric α1-subunit and the wild type human α1-subunit at protein level are ten amino acid substitutions.

When considering the aspect of the invention relating to the selection of gene-modified cells, it is underlined that the selection process relies on a particularly rapid elimination of human cells by ouabain via inhibition of ion transport across the plasma membrane. Therefore, the selection process is not genotoxic and this is, to the best knowledge of the inventors, the first time when high ouabain resistance has been obtained for a substantially human gene. The resulting unprecedented level of resistance makes it possible to utilize this mutated gene as a selection marker for very rapid elimination of unmodified human cells. This marker may have applications in gene therapy applications for a wide array of human diseases and disabilities, as well as for genetic modifications of cells in culture.

Moreover, this selection marker can advantageously be used together with so called suicide genes, genes inducing cell death.

The present invention is based on a gene expressed in all cell types and provides an advantageous selection system to current selection/sorting markers. Since the amino acid sequence encoded for by the nucleic acid construct of the invention has at least 98%, and preferably more than 99% homology to the human wild type Na⁺, K⁺-ATPase α1-subunit, the probability of immunogenicity is highly unlikely.

An additional advantage is that ouabain is a well-known, relatively inexpensive pharmaceutical; it has been widely used in the clinic as a cardiac medicine. Ouabain has no known toxic effects apart from its action as an inhibitor of Na⁺, K⁺-ATPase, it can be quickly removed form a cell culture by a simple wash and gives no false-positive selection. Its rapid course of action in the cell culture settings allows for quick selection of transiently transfected or stably transduced cells In summary, the selection is rapid, 24-48 h in most cell types, and does not give false positive results. These properties can make this human mutated construct a favoured selection marker for use in pre-clinical and clinical molecular medicine.

Ouabain binds to Na⁺, K⁺-ATPase extracellurlarly and the junction between the first and second transmembrane spanning regions (H1-H2 junction) is believed to strongly influence the level of ouabain resistance of the α1-subunit. The H1-H2 junction exposed extracellularly include amino acids number 118-129 (the numbering established according to SEQ ID NO. 1 or functionally equivalent homologues thereof), Four of five consistent interspecies residue differences in the first about 130 amino acids are in the H1-H2 junction, i.e. corresponding to the amino acids no. Q118, A119, Q126, and N129 in the human Na⁺, K⁺-ATPase α1-subunit sequence of SEQ ID. NO. 1 or the corresponding amino acids in functionally equivalent homologues thereof. The membrane anchored residues flanking the H1-H2 junction are also believed to be important for ouabain affinity.

One aspect of the invention is a recombinant Na⁺, K⁺ ATPase α1-subunit, said recombinant protein is at least 98% homologous to the corresponding human Na⁺, K⁺ ATPase α1-subunit at the amino acid level, wherein the amino acid sequence of said human protein is the sequence of SEQ ID. NO. 1 or any functionally equivalent homologue thereof, and where the recombinant Na⁺, K⁺ ATPase α1-subunit is more resistant to ouabain than the corresponding human protein.

The inventors have shown that the location of the substitutions is of significant importance. Consequently, a preferred aspect of the invention is a recombinant Na⁺, K⁺ ATPase α1-subunit, wherein the differences between said protein and the corresponding human Na⁺, K⁺ ATPase α1 -subunit are situated within the first about 130 amino acids, wherein the amino acid sequence of said human protein is the sequence of SEQ ID NO. 1, or any functionally equivalent homologue thereof.

The work performed by the present inventors has demonstrated that said differences in the amino acid sequence between the α1-subunit of said protein and the corresponding human Na⁺, K⁺ ATPase α1-subunit are preferably situated between and including the amino acids number 65-133, and most preferably limited to at least one of the amino acids situated between and including the amino acids number 117-130 (comprising also the first membrane anchored residues flanking the H1-H2 junction) wherein the amino acid sequence of said human protein is the sequence of SEQ ID NO. 1, or any functionally equivalent homologue thereof. In one embodiment of the present invention the said protein differs from the corresponding human Na⁺, K⁺ ATPase α1-subunit with respect to a maximum of 10 of the amino acids situated between and including the amino acids number 117-130, more preferably a maximum of 4 of the amino acids situated between and including the amino acids number 117-130, and most preferably a maximum of 2 of the amino acids situated between and including the amino acids number 117-130, wherein the amino acid sequence of said human protein is the sequence of SEQ ID. NO. 1 or any functionally equivalent homologue thereof.

In one embodiment the recombinant α1-subunit differs from the corresponding human Na⁺, K⁺ ATPase α1-subunit in the identity of the amino acids number 118 and 129, most preferably the mutations Q118R and N129D, wherein the amino acid sequence of said human protein is the sequence of SEQ ID NO. 1 or any functionally equivalent homologue thereof.

A recombinant protein according to the present invention exhibits high resistance to ouabain; and preferably said protein is resistant to ouabain, at least at an ouabain concentration of 10⁻⁷ M. More preferably said protein is resistant to an ouabain concentration of at least 10⁻⁵ M and most preferably at least 10⁻³ M.

The present invention makes available a recombinant Na⁺, K⁺ATPase α1-subunit, as defined above, further characterized in that the said protein comprises the amino acid sequence of SEQ ID NO. 2 or any functionally equivalent homologue thereof, preferably the sequence of SEQ ID NO. 23 or any functionally equivalent homologue thereof.

Another aspect of the invention is a nucleic acid construct encoding the recombinant Na⁺, K⁺ ATPase protein α1-subunit having at least 98% homology to human Na⁺, K⁺-ATPase α1-subunit as defined above, and in particular a nucleic acid construct wherein the encoded amino acid sequence differ from the corresponding human Na⁺, K⁺ ATPase α1-subunit in amino acid residues situated between and including the amino acids corresponding to number 65-133 of SEQ ID NO. 1 or any functionally equivalent homologue thereof. When the construct is expressed in a cell it confers increased resistance to cardiac glycosides and other Na⁺, K⁺ ATPase inhibitors and especially one of, but not limited to, ouabain, digoxin and digitoxin, proscillaridine A, palytoxin and convallatoxin.

According to one embodiment of the invention, the nucleic acid construct comprises the sequence given in SEQ ID NO. 3, or a functionally equivalent homologue thereof.

The present invention also makes available a new method for producing a recombinant, ouabain resistant Na⁺, K⁺ ATPase α1-subunit as defined above. In this method, the 5′-end of the human Na⁺, K⁺ ATPase α1-subunit cDNA is modified to produce a recombinant protein that is at least 98% homologous to the corresponding human Na⁺, K⁺ ATPase α1-subunit at amino acid level, said modifications are amino acid substitution situated between and including the amino acids number 65-133 of SEQ ID NO. 1 or any functionally equivalent homologue thereof.

According to one embodiment of the inventive method the 5′-end of the human Na⁺, K⁺ ATPase α1-subunit cDNA is modified to introduce at least one site-directed mutation in the coding sequence, thereby substituting at least one amino acid with respect to the amino acids between and including the amino acids number 117-130 wherein the amino acid sequence of said human protein is the sequence of SEQ ID. NO. 1 or any functionally equivalent homologue thereof.

According to another embodiment of the method according to the invention, the 5′-end of the human Na⁺, K⁺ ATPase α1-subunit cDNA is modified to introduce specific changes of the amino acids sequence of the protein, said changes consisting of a maximum of 10 site-directed mutations in the coding sequence, thereby substituting amino acids situated between and including the amino acids number 117-130, more preferably a maximum of 4 substitution of the amino acids situated between and including the amino acids number 117-130, and most preferably a maximum of 2 substitution of the amino acids situated between and including the amino acids number 117-130 wherein the amino acid sequence of said human protein is the sequence of SEQ ID NO. 1, or any functionally equivalent homologue thereof.

In one embodiment of the inventive method, the recombinant α1-subunit is modified to differ from the corresponding α1-subunit of the human Na⁺, K⁺ ATPase protein in the amino acids number 118 and 129 (sequence numbering according to SEQ ID NO. 1 or the corresponding amino acids in functional equivalent homologues thereof), and most preferably the substitutions Q118R and N129D. The corresponding sequences are attached as SEQ ID NO. 23 (protein) and SEQ ID NO. 24 (coding sequence).

According to another embodiment of the method of the invention, the recombinant Na⁺, K⁺ ATPase α1-subunit confers resistance to at least 10⁻⁷ M ouabain when expressed in a cell. Preferably the nucleic acid construct confers resistance to at least 10⁻⁵ and more preferably at least 10⁻³ M oubain.

The invention also relates to a method wherein the recombinant Na⁺, K⁺ ATPase α1-subunit of the invention confers resistance to other cardiac glycosides and other Na⁺, K⁺-ATPase inhibitors, such as, but not limited to, digoxin and digitoxin, proscillaridine A, palytoxin and convallatoxin.

Further, the present invention makes available a step in a method of gene therapy wherein a recombinant cardiac glycoside resistant marker, such as the ouabain resistant Na⁺, K⁺ ATPase α1-subunit as defined above, is used in methods for in vitro selection of gene-modified cells.

Methods for in vitro selection of gene-modified cells are well known to a person skilled in the art. In general terms, such methods can comprise the following steps: First, stable cultured cell lines or primary human cells of donor or patient origin are propagated in cell culture media. Second, gene transfer, i.e. transfer of genetic information in the form of natural, or synthetic, or modified nucleic acids or their analogues is performed with the help of electric, chemical or biological means, such as electroporation, transfection, or viral gene transfer (transduction). This however results in gene transfer only to a fraction of the cells.

Consequently, as a third step, the resulting gene-modified cell population needs to be isolated from the unmodified cells by separation, e.g. chemical selection: the transferred genetic material in addition to carrying a therapeutically active gene or genes, also carries a selectable gene conferring resistance to toxic substances, or medical drugs at toxic concentrations. Subjecting the modified and unmodified cell mixture to a toxic substance or a mixture of substances carries out the selection. The substance/-es induce/s cell death in unmodified cells, but not in the gene-modified cell population. Thus, a pure population of gene-modified cells is obtained after selection.

According to the present invention, a cardiac glycoside such as ouabain is used as the toxic substance, and a nucleic acid sequence coding for the recombinant Na⁺, K⁺ ATPase α1-subunit conferring ouabain resistance as disclosed herein is included in the genetic material to be transferred.

Further, the present invention makes available a step in a method used for the study of mechanisms of toxicity wherein a recombinant cardiac glycoside resistant marker, such as the ouabain resistant recombinant Na⁺, K⁺ ATPase α1-subunit as defined above, is used in methods for in vitro or in vivo studies.

Methods for in vitro toxicity studies are well known to a person skilled in the art. In general terms, such methods can comprise, e.g. studies involving the induction of cell death using substances acting on the cell membrane ion channels and thus influencing the electrochemical gradient across the plasma membrane and ion homeostasis. In such studies, the test cells are grown in cell culture and the response of the cells to different test substances is registered. According to the present invention, the test cells are modified to express the ouabain resistant recombinant Na⁺, K⁺ ATPase α1-subunit construct and the change in the cell viability and pattern of cellular chemical signalling response is registered.

Further, the present invention makes available an ouabain resistant recombinant Na⁺, K⁺ ATPase α1-subunit as defined above for use in pharmacological studies of substances directly or indirectly influencing the human Na⁺, K⁺ ATPase.

A person skilled in the art knows various methods for pharmacological studies, and modifications of such methods can be made relying on literature and on the information disclosed in the present description and examples. In general, such studies involve induction of changes in cellular metabolism in response to chemical stimuli, or gene transfer. An example of such methods comprises the following steps: First, the test cells are grown in cell culture and the response of the cells to test substances or genetic manipulations is registered. According to the present invention, the cells are modified to express the ouabain resistant recombinant Na⁺, K⁺ ATPase α1-subunit construct and the change in the pattern of cellular functioning is registered. Pharmacological studies could also be performed in vivo.

The present invention also encompasses a nucleic acid construct as defined above or any functionally equivalent homologue thereof, wherein said construct forms a functional part of a gene-transfer vector. The transfer vector is preferably a plasmid, a viral vector, or any hybrid construct thereof.

Further, a particular embodiment of the present invention is a gene-modified natural, partly or completely synthetic cell comprising such nucleic acid construct as defined above or any functionally equivalent homologue thereof. Preferably said cell is a eukaryotic cell or a human chimeric cell, and most preferably a human cell.

Further, a particular embodiment of the present invention is a cell expressing the ouabain resistant recombinant Na⁺, K⁺ ATPase α1-subunit transferred by carriers such as exosomes and liposomes or functional equivalents thereof

The present invention will be further described in the following non-limiting examples.

EXAMPLES

1. Materials and Methods

1.1 Constructs & Plasmids

A plasmid encoding the wild type rat Na⁺, K⁺-ATPase α1 (pCMVOuab′) was purchased from Pharmingen (San Diego, Calif.). Human Na⁺, K⁺-ATPase α1 cDNA as a plasmid (phNKAa1) was kindly provided by J. B. Lingrel (Dept Mol Gene, Biochem and Microbiol, Univ Cincinnati College of Medicine, Cincinnati, Ohio). L-799 in pCMVOuabr was mutated to a cysteine by site-directed mutagenesis and named OuaR (Aints et al., Human Gene Therapy, 13:969-977, 2002). pEGFP-OuaR (pEGFPR) was made by inserting an ApaI-XbaI fragment from pCMV-OuaR between the ApaI and XbaI sites of pEGFP-C3 (Clontech, Palo Alto, Calif.). A pEGFP-hNKAα1 plasmid (pEGFPH) was made by inserting a NcoI (filled)—XbaI fragment from phNKAα1 between SmaI and XbaI in pEGFP-C1 (Clontech, Palo Alto, Calif.). The results in both cases were in-frame fusions between the inserted protein and EGFP. A pEGFP-hNKAα1-PX (H3R) chimeric fusion gene was made by substitution of the nucleotide sequence PfuMI-XbaI with the homologue fragment of pEGFP-OuaR. The pEGFP-hNKAa1-PV (H3R4H) and pEGFP-hNKAa1-VX (H4R) chimeric fusion genes were made by substitution of the nucleotide sequence PfuMI-Ppu MI and Ppu MI-XbaI with the homologue fragments of pEGFP-OuaR respectively. To make chimeras in the 5═-end of the Na⁺, K⁺-ATPase α1, segments of OuaR were amplified with the following primers: (SEQ ID NO. 4) GGAACCTCAAAACGATAATCTGTACCTCGGGGTCGTGC, (forward) (SEQ ID NO. 5) TCATCACGGGTGTGGCTGTGTTCCTGGGGGTGTCTT, (forward) (SEQ ID NO. 6) AAGACACACCCAGGAACACAGCCACACCCGTGATGAGG, (reverse) (SEQ ID NO. 7) AGCACCACACCCAGGTACAGATCATCATTTGGTGGTTCC, (reverse) and (SEQ ID NO. 8) GGCAAGCTTGTTATCTAGA. (reverse)

Segments of pEGFPH were amplified with the following primers: (SEQ ID NO. 9) GGAACCACCAAATGATGATCTGTACCTGGGTGTGGTGCT, (forward) (SEQ ID NO. 10) CCTCATCACGGGTGTGGCTGTGTTCCTGGGTGTGTCTT, (forward) (SEQ ID NO. 11) GCACGACCCCGAGGTACAGATTATCGTTTTGAGGTTCC, (forward) (SEQ ID NO. 12) AAGACACCCCCAGGAACACAGCCACACCCGTGATGA, (reverse) and (SEQ ID NO. 13) GCGAAGCTTGACGGGGGGCTAATAGTAGGT. (reverse)

The primer: CGGGATCACTCTCGGCATGGAC (forward) (SEQ ID NO. 14) was used for both constructs. The crossover points were at position bp390 and bp900 from the 5′end of the gene. The chimeric constructs cloned by PCR were: H1R. R1H, R1H4R, R1H3R, R1H3R4H, H1R2H3R, H1R2H3R4H, H1R2H4R, R1H2R.

H=human, R=rat, 1=up to first cross over point, 2=up to second cross over point, 3=following PfuMI restriction site, 4=following Ppu MI restriction site. PCR products were gel purified and cloned into TOPO vectors (Invitrogen) and amplified by transformation of One-Shot E. coli (Invitrogen) according to the protocols supplied by the manufacturer. Plasmids were purified from the bacteria using the Quiaprep miniprep (Quiagen) according to the protocol supplied by the manufacturer. The PCR constructs were excised from the Hind III sites in the plasmids and gel purified. The fragments were inserted into the Hind III site in the EGFP-C1 or EGFP-C3 plasmids (Clontech, Palo Alto, Calif.) to create an in frame fusion with EGFP. All constructs with the 5′-end of rat gene sequence were inserted into the EGFP-C3 plasmid and constructs with the 5′-end of human sequence were inserted into the EGFP-C1 plasmid. The plasmids were amplified in One-Shot E. coli (Invitrogen) and purified using Quiaprep miniprep (Quiagen). Constructs were confirmed by restriction enzyme mapping and partial sequencing.

1.2 Transfection and Ouabain Toxicity Assay

HeLa cells (ATCC, Manassas, Va.) were cultured in DMEM Glutamax with 10% heat-inactivated fetal bovine serum (FBS). For transfections, Fugene 6 reagent (Roche Boehringer Mannheim, Germany) was used according to manufacturer's description. Briefly, 2 μg of plasmid DNA per 10⁵ cells were complexed with 5 μl of the reagent in a 100 μl volume of cell culture medium and added to cells after 15 min of incubation. After 24 h, ouabain was added to each well to a final concentration of 10 μM. Cell viability was documented following 24 h incubation.

COS-7 cells (ATCC, Manassas, Va.) were cultured and transfected as above. After 48 h incubation in 10 μM ouabain, the cells were washed twice in PBS (Gibco) and incubated for 15 min in 0,025% porcine trypsine in saline (Sigma). The trypsin was inactivated by FBS addition. The cells were re-incubated in 10 μM ouabain. Cell viability was documented following 48 h incubation.

2. Results

2.1 Sub-Cellular Localisation

To monitor the transfection process and sub-cellular localisation of the mutated protein, EGFP-chimeric human/rat Na⁺,K⁺-ATPase α1 fusion genes were constructed. Transfection of COS-7 and HeLa cells with pEGFP-chimeric fusion genes resulted in the localization of the fusion protein in the cell membrane. pEGFPR was used as a positive control in the transfection experiments. pEGFPH expression did not confer ouabain resistance on COS-7 cells. Moreover, over-expression of the human Na⁺,K⁺-ATPase α1 gene naturally expressed in HeLa by transfection of pEGFPH did not influence ouabain sensitivity. The controls, pEGFPR, pEGFPH, as well as the chimeric EGFP fusion proteins were localised in the cell membrane and detectable by GFP fluorescence. Posttranslational regulation of Na⁺,K⁺-ATPase α1 expression is controlled by the levels of its cognate β subunit. In transfected cells, the plasmid-encoded protein is competing with the endogenous a subunit for the β subunit and unassembled α-subunits are rapidly degraded (Shanbaky and Pressley, Biochem. Cell Biol., 1995, 73:261-268).

2.2 Ouabain Sensitivity

Sensitivity of the transfected chimeric cDNA to ouabain toxicity was measured in vitro. 10 μM of ouabain induces cell death of wild type HeLa and COS-7, while the rat OuaR construct confers resistance to ouabain and rescues HeLa and COS-7 expressing this α1-subunit. Cell viability of transfected HeLa was documented after 24 h incubation in ouabain. Cell viability of transfected COS-7 was documented after 48 h incubation, followed by trypsination and another 48 h of 10 μM ouabain exposure. Cells transfected with chimeric cDNA with the 5′-end of the chimeric cDNA of rat sequence were resistant to 10 μM ouabain whereas cells transfected with constructs with the 5′-end of human sequence were killed by ouabain induced cell death (FIG. 1), regardless of the constitution the remaining parts of the cDNA. The positive control (pEGFPR) conferred resistance to the transfected cells while the negative control (pEGFPH) and untransduced cells were eliminated by the ouabain exposure. Therefore, the amino acids critical for the 10 μM ouabain-resistant phenotype are situated in the amino terminal of the chimeric α1-subunit, more precisely within the first 129 amino acids. The ouabain-binding site is assumed to be close to the membrane on the extracellular surface. Thus, the present inventors believe the amino acids within and flanking the H1-H2 junction to be of particular importance for the 10 μM ouabain resistance-phenotype of the rat-human chimeric α1-subunit protein.

Experimental Part Added During the Priority Year

3. Materials and Methods

3.1 Site Directed Mutagenesis

pEGFPH was used as template to make H-Q118R, H-Q118R;A119S, H-Q126P;N129D, H-N129D. The following primers were used to make overlapping segments, which were joined and amplified by PCR: (SEQ ID NO 15) TTGTTTCTTGGCTTATAGTATCCGAGCTGCTACAGAAGAGGAACCT (Q118R forward) (SEQ ID NO 16) AGGTTCCTCTTCTGTAGCAGCTCGGATACTATAAGCCAAGAAACAA (Q118R reverse) (SEQ ID NO 17) TTGTTTCTTGGCTTATAGTATCCGATCAGCTACAGAAGAGGAACCT (Q118R;A119S forward) (SEQ ID NO 18) AGGTTCCTCTTCTGTAGCTGATCGGATACTATAAGCCAAGAA ACAA (Q118R;A1195 reverse) (SEQ ID NO 19) AGAAGAGGAACCTCCAAACGATGATCTGTACCTGGG (Q126P;N129D forward) (SEQ ID NO 20) CCCAGGTACAGATCATCGTTTGGAGGTTCCTCTTCT (Q126P;N129D reverse) (SEQ ID NO 21) AGAAGAGGAACCTCAAAACGATGATCTGTACCTGGG (N129D forward) (SEQ ID NO 22) CCCAGGTACAGATCATCGTTTTGAGGTTCCTCTTCT (N129D reverse)

The above cDNAs coding for one or two amino acid substitution were used as templates to make H(Q118R; A119S; Q126P; N129D), H(Q118R; Q126P; N129D), H(Q118R;N129D) and H(Q118R; A119S; N129D) and again using the above primers. These constructs were cloned into TOPO vectors (Invitrogen) as described for chimeric cDNAs. An Acc I excised fragment of the clones, containing the mutated region, were inserted into and substituting an Acc I cut pEGFPH. The final cDNAs were as follows; pEGFPH-Q118R; A119S; Q126P; N129D, pEGFPH-Q118R; Q126P; N129D, pEGFPH-Q118R;N129D, pEGFPH-Q118R; A119S; N129D pEGFPH-Q118R pEGFPH-Q118R;A119S pEGFPH-Q126P;N129D pEGFPH-N129D. These constructs were amplified by transformation and prepared as described for chimeric cDNAs. Restriction enzyme mapping and partial sequencing confirmed mutated cDNAs.

3.2 Cell Line

Human epithelial carcinoma HeLa (ATCC, Manassas, Va., USA), Phoenix GP (lymphoblast C1R-sB7) obtained from ATCC with permission from Dr. G Nolan at Dept. of Molecular Pharmacology, Stanford University Medical Center, Stanford, Calif., USA) and mouse retrovirus producer cell line PG13 carrying the GaLV envelope, were cultured in Dulbecco's modified minimal essential medium (DMEM) Glutamax-1 and 10% heat inactivated fetal calf serum (Gibco). For propagation cells were washed twice in PBS (Gibco) and incubated for about 5 min in 0,025% porcine trypsine in saline (Sigma). The trypsine was inactivated by addition of FBS.

3.3 DNA Transfection and Ouabain Toxicitv Assay

For transfections, Fugene 6 reagent (Roche Boeringer Mannheim, Germany) was used according to the manufacturer's instructions. Briefly, 2 μg of plasmid DNA per 10⁵ cells were complexed with 5 μl of the reagent in a 100 μl volume of cell culture medium DMEM Glutamax and added to cells after 15 min of incubation. Ouabain (Sigma, St. Louis, Mo., USA) was dissolved in DMEM as a stock solution of 10 mM. For selection experiments 10-500 μM was used. Ouabain was added to the cells at 24 h after transfection. At 48 hours post transfection the cells were trypsinized and transferred to ouabain-free medium. Cell survival was quantified spectrophoto-metrically using the WST-1 cell proliferation reagent (Roche) according to the manufacturer's instructions.

3.4 Retrovirus Vector Construct

pMP91_(MCS) was made by inserting the 700 bp Nhe l; Xho I 3′-LTR fragment from pMP71-EGFP containing a multiple cloning site was inserted in the Xba I site in SF91_(MCS). The retrovirus vector pMP91-H(Q118R;N129D) was made as a 3-point DNA ligation of the vector pMP91_(MCS) cut wth Hind III and Sal I, a Hind III; Bgl II fragment of the pGCI-H(Q118R;N129D) and a Bgl II; SaI fragment from pGC3-R1^(st)H (containing a PCR introduced Hind III site downstream of the stop codon).

3.5 Production of Viral Supernatant

Recombinant retrovirus vectors were produced by transient transfection of Phenix GP. Cells were plated at a concentration of 100000 in a 6-well plate. The next day cells were transfected with 3.75 μg of vector plasmid and 0.75 μg of pMDG (provided by D. Trono, Dept of Genetics and microbiology, University of Geneva, Geneva, Switzerland) encoding the vesicular stomatitis virus glycoprotein (VSV-G) using Fugene 6 reagent following the above protocol. 48 hours after transfection the supernatant was collected, fiftered and frozen in aliquots at −70° C. The VSV-G pseudotyped retroviral vectors were used to produce PG13 GALV-pseudotype producer cell pools. PG13 cells were plated at a number of about 23000 in a 6-well plate and transduced using 1 ml of the VSV-G. Polybrene was used at a concentration of 4-8 μg/ml. Six rounds of transductions were performed on six consecutive days. The producer cell pools were expanded and used to produce supematants. Supernatant was collected, filtered through 0.45 μm filters and frozen.

3.6 Transduction and Selection of HeLa

HeLa were seeded to a 6-well plate at a density of 10⁵ per well. 200 μl of frozen pMP91-H(Q118R;N129D) supernatant collected form the PG13 producer cell pool about 5000 TU/ml was warmed to 37° C. and added to the cells. Also, 8 μg/ml of polybrene was added. At 24 hours post transduction ouabain was added to the culture at a concentration of 10 μM. After 48 hours of ouabain selection, cells were washed twice in PBS. Then transduced and selected cells were propagated in ouabain-free medium.

4. Results

4.1 Engineered Resistance of the Human Protein to Ouabain

The present inventors set out to determine the critical amino acids contributing to increased ouabain resistance of the chimeric rat-human Na⁺,K⁺-ATPase α1 cDNA. The ouabain binding site is assumed to be close to the membrane on the extracellular surface. Therefore the inventors postulated that the amino acids within and adjacent to the H1-H2 junction would be of particular importance for the 10 μM ouabain resistance-phenotype. Since four positions within the H1-H2 junction (position #118-129, human amino acid sequence) differ between human and rat α1 subunit sequence, the inventors assumed these positions Q118, A119, Q126, and N129 to be critical for the ouabain resistance of the chimeric rat-human Na⁺,K⁺-ATPase α1 cDNA. Substituting the amino acids at these positions; human to rat Q118R, A119S, Q126P, N129D in the human cDNA, it could be assessed if, and if so, which of these were required and sufficient to increase resistance of the recombinant human Na⁺,K⁺-ATPase α1 subunit to 10 μM ouabain. Amino acid substitutions were made by site directed mutagenesis using PCR techniques. The mutant genes were HQ118R; A119S; Q126P; N129D, H-Q 118R; A119S; Q126P, H-Q118R; A119S, H-Q126P; N129D, H-Q118R; N129D, H-Q118R, and H-N129D. The mutated human cDNAs were fused in frame with EGFP in the GC1 plasmid using the method described for the chimeric cDNAs.

4.2 Transfection and Selection of Human Cell Lines

HeLa cells were transfected with plasmids carrying the EGFP-mutated human cDNAs followed by 24 hours incubation in 10 μM ouabain 24 h post transfection. The mutated genes H-Q118R; A119S; Q126P; N129D, H-Q118R; A;119S; Q126P, and H-Q118R; N129D conferred resistance to ouabain, but H-Q118R; A119S, H-Q126P; N129D, H-Q118R, and H-N129D did not. In conclusion, substitutions at two positions; Q118R and N129D, were required and sufficient to confer resistance to 10 μM ouabain of the human Na⁺, K⁺-ATPase α1. To determine to what level the minimally mutated human Na⁺, K⁺-ATPase α1 conferred ouabain resistance, a dose response assay was performed. HeLa cells were transiently transfected with the plasmid pEGFPH-Q118R; N129D, or pEGFPR. At 24 h the cells expressed sufficient amount of the fusion gene to be selected with ouabain. The transfected cells were selected in various concentration of ouabain (10-500 μM) for 24 hours, then transferred to ouabain-free medium and quantified using the WST-1 proliferation agent. The results are represented in FIG. 2. Control and un-transfected cells were eliminated after 24 hours of ouabain while cells transfected with either the rat OuaR or the human Q118R; N129D substituted Na⁺, K⁺-ATPase α1 cDNAs were rescued at 10 and 100 μM ouabain concentrations. 500 μM ouabain was toxic to cells transfected with the mutated human construct and also exhibited some general toxicity to cells transfected with the rat OuaR. Cell debris and cells detached during the ouabain selection were washed and transferred to ouabain-free medium. No surviving cells were observed from detached cells and debris (data not shown).

4.3 Retrovirus Vector Production and Gene Transfer

Using MP91H-Q118R; N129D retrovirus producer cell pools of PG13 we were able to transduce the H-Q118R; N129D cDNA into target HeLa cells. The multiplicity of infection (MOI) was <0.05. Therefore, transduced cells were extremely unlikely to have integrated more than one retrovirus copy per cell. To obtain a pure population of transduced cells, 10 μM ouabain was added 24 h post-transduction for 48 h. The selected cell population was further expanded and propagated in ouabain-free growth medium. Transient transfection with plasmid DNA transfers up to thousands of gene copies per cell resulting in a high transgene expression. In this experiment it was found that only one gene copy expresses the H-Q118R; N129D cDNA in sufficient amounts to confer resistance to 10 μM ouabain.

Although the invention has been described with regard to its preferred embodiments, which constitute the best mode presently known to the inventors, it should be understood that various changes and modifications would be obvious to one having the ordinary skill in the art and may be made without departing from the scope of the invention as set forth in the claims appended hereto. 

1. A recombinant Na⁺, K⁺ ATPase protein comprising an α-subunit and a β-subunit characterized in that the α-subunit is the α1-isoform, the α1-subunit of said recombinant protein is at least 98% homologous to the corresponding α1-subunit of a human Na⁺, K⁺ ATPase protein at the amino acid level, wherein the α1-subunit amino acid sequence of said human protein is the sequence of SEQ ID. NO. 1 or any functionally equivalent homologue thereof; the α1-subunit of said protein differs from the corresponding α1-subunit of the human Na⁺, K⁺ ATPase are protein with respect to at least one of the amino acids the 1-subunit situated between and including the amino acids number 117-133; and the recombinant Na⁺, K⁺ ATPase protein is resistant to a cardiac glycoside chosen among oubain, digoxin, digitoxin, proscillaridine A, palytoxin and convallatoxin.
 2. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein the α1-subunit of said protein differs from the corresponding α1-subunit of the human Na⁺, K⁺ ATPase protein with respect to a maximum of 10 of the amino acids situated between and including the amino acids number 117-130.
 3. The recombinant protein Na⁺, K⁺ ATPase according to claim 1, wherein the α1-subunit of said protein differs from the corresponding α1-subunit of the human Na⁺, K⁺ ATPase protein in a maximum of 4 of the amino acids situated between and including the amino acids number 117-130.
 4. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein the α1-subunit of said protein differs from the corresponding α1-subunit of the human Na⁺, K⁺ ATPase protein in a maximum of 2 of the amino acids situated between and including the amino acids positions 117-130.
 5. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein the amino acid in position 118 is substituted from glutamine to arginine and the amino acid at position 129 is substituted from asparagine to aspartate.
 6. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein the α1-subunit of said protein differs from the corresponding α1-subunit of the human Na⁺, K⁺ ATPase protein in the amino acids positions 118 and
 129. 7. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein said protein is resistant to at least 10⁻⁷M ouabain.
 8. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein the α1-subunit of said protein comprises the sequence of SEQ ID. NO.
 2. 9. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein the α1-subunit of said protein comprises the sequence of SEQ ID. NO.
 23. 10. A nucleic acid construct or a functional homologue thereof, encoding the α1-subunit of a recombinant Na⁺, K⁺ ATPase protein, said protein as defined in claim
 1. 11. The nucleic acid construct according to claim 10, wherein the nucleic acid construct is the sequence of SEQ ID NO. 3 or any functionally equivalent homologue thereof.
 12. The nucleic acid construct according to claim 10, wherein the nucleic acid construct is the sequence of SEQ ID NO. 24 or any functionally equivalent homologue thereof.
 13. (canceled)
 14. A method for producing a recombinant ouabain resistant Na⁺, K⁺ ATPase protein, characterized in that the human Na⁺, K⁺ ATPase α1-subunit gene is modified to produce a recombinant α1-subunit protein that is at least 98% homologous to the corresponding human Na⁺, K⁺ ATPase α1-subunit at the amino acid level, said modifications being amino acid substitutions situated between and including the amino acids number 117-133 of SEQ ID NO.
 1. 15. The method according to claim 14, wherein the human Na⁺, K⁺ ATPase α1-subunit cDNA or gene is modified to introduce at least one amino acid substitution with respect to the amino acids between and including the amino acids number 117-130.
 16. The method according to claim 14, wherein the human Na⁺, K⁺ ATPase α1-subunit gene is modified to introduce specific amino acid substitutions, said changes consisting of a maximum of 10 substitutions of the amino acids between and including the amino acids number 117-130.
 17. The method according to claim 14, wherein the human Na⁺, K⁺ ATPase α1-subunit cDNA or gene is modified to introduce specific substitutions of the amino acids of the protein, said changes consisting of a maximum of 4 substitutions of the amino acids between and including the amino acids number 117-130.
 18. The method according to claim 14, wherein the 5-end of the human Na⁺, K⁺ ATPase α1-subunit cDNA or gene is modified to introduce specific substitutions of the amino acids of the protein, said changes consisting of a maximum of 2 substitutions of the amino acids between and including the amino acids number 117-130.
 19. The method according to claim 14, wherein the human Na⁺, K⁺ ATPase α1-subunit cDNA or gene is modified to introduce specific substitutions of the amino acids of the protein, said changes being substitutions of the amino acids number 118 and
 129. 20. A step in a method of gene therapy, characterized in that the recombinant protein according to claim 1 is used for in vitro selection of gene-modified cells.
 21. A step in a method of gene therapy, characterized in that the recombinant protein according to claim 1 is used for in vitro selection of gene-modified cells and wherein the selection is performed in 24-48 h.
 22. A recombinant protein according to claim 1 for use in pharmacological studies of substances directly or indirectly influencing the mammalian Na⁺, K⁺ ATPase.
 23. A nucleic acid construct or any equivalent homologues thereof, according to claim 12, wherein said construct forms a functional part of a gene-transfer vector.
 24. A gene-modified primary normal human or human tumour cell of donor, patient, or third part origin or any mix thereof, human chimeric, or non-human, partly or completely natural or synthetic cell comprising a nucleic acid construct according to claim
 12. 25. A gene-modified cell according to claim 27, wherein the cell is a eukaryotic cell.
 26. A gene-modified cell according to claim 27, wherein the cell is a human cell.
 27. A primary normal human or human tumour cell of donor, patient, or third part origin or any mix thereof, human chimeric, or non-human, partly or completely natural or synthetic cell expressing a recombinant protein according to claim 1 transferred by mechanisms such as exosomes and liposomes or functional equivalents thereof.
 28. A nucleic acid construct or a functional homologue thereof, encoding the α1-subunit of a recombinant Na⁺, K⁺ ATPase protein, said protein as defined in claim
 9. 29. A nucleic acid construct or a functional homologue thereof, encoding the α1-subunit of a recombinant Na⁺, K⁺ ATPase protein, said protein as defined in claim
 8. 30. A nucleic acid construct or any equivalent homologues thereof, according to claim 12, wherein said construct forms a functional part of a viral gene-transfer vector.
 31. A nucleic acid construct or any equivalent homologues thereof, according to claim 11, wherein said construct forms a functional part of a gene-transfer vector.
 32. A nucleic acid construct or any equivalent homologues thereof, according to claim 11, wherein said construct forms a functional part of a viral gene-transfer vector.
 33. A gene-modified primary normal human or human tumour cell of donor, patient, or third part origin or any mix thereof, human chimeric, or non-human, partly or completely natural or synthetic cell comprising a nucleic acid construct according to claim
 11. 34. A step in a method of gene therapy, characterized in that the recombinant protein according to claim 9 is used for in vitro selection of gene-modified cells.
 35. A step in a method of gene therapy, characterized in that the recombinant protein according to claim 9 is used for in vitro selection of gene-modified cells and wherein the selection is performed in 24-48 h.
 36. A step in a method of gene therapy, characterized in that the recombinant protein according to claim 8 is used for in vitro selection of gene-modified cells.
 37. A step in a method of gene therapy, characterized in that the recombinant protein according to claim 8 is used for in vitro selection of gene-modified cells and wherein the selection is performed in 24-48 h.
 38. A step in a method used in the study of mechanisms of toxicity, characterized in that the recombinant protein according to claim 9 is used for in vitro studies.
 39. A recombinant protein according to claim 9 for use in pharmacological studies of substances directly or indirectly influencing the mammalian Na⁺, K⁺ ATPase.
 40. A step in a method used in the study of mechanisms of toxicity, characterized in that the recombinant protein according to claim 8 is used for in vitro studies.
 41. A recombinant protein according to claim 8 for use in pharmacological studies of substances directly or indirectly influencing the mammalian Na⁺, K⁺ ATPase.
 42. A primary normal human or human tumour cell of donor, patient, or third part origin or any mix thereof, human chimeric, or non-human, partly or completely natural or synthetic cell expressing a recombinant protein according to claim 9 transferred by mechanisms such as exosomes and iiposomes or functional equivalents thereof.
 43. A primary normal human or human tumour cell of donor, patient, or third part origin or any mix thereof, human chimeric, or non-human, partly or completely natural or synthetic cell expressing a recombinant protein according to claim 8 transferred by mechanisms such as exosomes and liposomes or functional equivalents thereof.
 44. The recombinant Na⁺, K⁺ ATPase protein according to claim 1, wherein said protein is resistant to at least 10⁻⁵M ouabain.
 45. The method according to claim 14, wherein the human Na⁺, K⁺ ATPase α1-subunit cDNA or gene is modified to introduce specific substitutions of the amino acids of the protein, said substitutions being a substitution of the amino acid glutamine in position 118 to the amino acid arginine and a substitution of the amino acid asparagine at position 129 to the amino acid aspartate.
 46. A step in a method used in the study of mechanisms of toxicity, characterized in that the recombinant protein according to claim 1 is used for in vitro studies. 